Dr. Marc Avram

The Donor Region

The donor region in hair transplantation is the only limiting factor in the procedure. It is important that  each patient s donor region be used efficiently and for the maximum cosmetic effect.  During the consultation each patient’s donor area is carefully evaluated.  The density or amount of hair follicles per square cm, will impact the expected number of hair follicles that can be transplanted during the procedure. 

The vast majority of patients have their  hair follicles  removed as a single  thin ellipse in the donor area . The removal of the ellipse of hair follicles  does leave a scar.  A typical scar is 2- 4 inches long and  as wide as a pen line . For most patients,  their exiting hair camouflages  the sutures during the post operative period and permanently camouflages the donor scar.    The only group of patients where it could be a concern is in those that either shave their hair or wear their hair very short .  Patients need to be aware of a visible scar if they do shave their hair. 

For patients that do prefer to wear their hair very short in the back or shave, another donor harvesting technique exists called follicular unit extraction (FUE).  This technique  utilizes  a 1 mm  punch to individually harvest one to three hair follicle groupings in the donor area.  The incisions are so small that, in most cases, there is no perceptible visible scar.  The limitations of this technique include increased  damage  of hair follicles , which may  lead to decreased growth of transplanted hair.

Hair Transplantation, An Overview

Hair transplantation consistently creates natural appearing transplanted hair for women and men.  The procedure is performed as an outpatient under local anesthesia. Over 3-4 hours, hundreds or thousands of  your own hair follicles are moved from the back of the scalp ,where they are not affected by male and female pattern hair loss, into zones of thinning hair in the frontal scalp. Since it is your own hair and taken from a region not affected male or female pattern hair loss it will grow for decades for most patients.

An unfortunate public legacy of the procedure is the “plug” and “corn rows” associated with the procedure in the popular culture. These unnatural appearing transplants resulted from poor surgical technique on the part of hair transplant surgeons in the past. Physicians used to create 10-20 hair grafts to transplant. These grafts were unnaturally large and therefore created the “pluggy” appearance from hair transplantation. Hair natural grows in 1-4 hair follicular bundles. Therefore if 1-4 hair grafts are used for transplantation they will consistently appear natural.

Dr Avram is a pioneer in the use of 1-4 hair grafts. Since completing his fellowship in hair transplantation after his dermatology residency in the mid 1990 s he has been dedicated to providing the safest highest quality procedure for his patients. He has given hundreds of invited lectures at national and international meetings, written papers, book chapters and textbooks on the subject. He and his entire staff are dedicated to answering all of your questions regarding your hair loss and determining what is the best treatment course for you .

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